Phlebotomy Standard Operating Procedures

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Phlebotomy is the act of drawing blood from the body. This is a specialized skill that is needed in the medical field. Blood draws are extremely common and can be performed in independent laboratories, hospitals, clinics and blood banks; some technicians will even come to your home to draw your blood. Some states require specific certification for phlebotomists, and others are more lenient about official certification. All states require phlebotomists to be well aware of the anatomy of the human body, proper technique, safety, infection control and patient rights.

Identifying Your Patient

  • First and foremost in phlebotomy is making sure you have identified your patient. You also must have a physician's orders to perform phlebotomy. In an outpatient setting such as an independent laboratory, the patient should be able to tell you his name and other identifying information, such as social security number and address, as well as provide picture identification to validate what he has said. In a hospital setting, it is imperative to check the patient's identification bracelet with the hospital orders so that you are certain you have the correct patient. If the patient is incorrectly identified, the results can be disastrous. Patients may be treated for the wrong condition, causing grave harm.

Supplies

  • Before you begin phlebotomy, you should arrange your supplies. You will need, at the very least, gloves, a tourniquet, a needle or lancet, a tube holder, the correct tubes for the tests you need to draw, alcohol, gauze and a bandage or tape. You should check the physician's orders to determine which tests are needed, and then gather the correct tubes and be certain of the order you are to draw them in. You should be absolutely certain there is a sharps container close by for disposal of the needle, and you should always have extra supplies nearby in case you drop something or find something that is not usable.

Ready to Begin

  • Once you have properly identified your patient and arranged your supplies, you will be ready to begin phlebotomy. You should first make sure your patient is comfortable, either seated in a phlebotomy chair or in his hospital bed. Introduce yourself and explain what you are going to do. Ask the patient if he is nervous and if he has ever had problems with phlebotomy before. Encourage the patient to ask questions, and advise him to tell you if he is uncomfortable at any point in the process.

Act of Phlebotomy

  • You should have all your supplies assembled and put on your gloves before you begin. Place a tourniquet on the patient's arm and identify the vein you will use. Clean the area with the appropriate antiseptic for the patient and the test ordered. Tell the patient he might feel a slight pinch before you pierce the skin. Quickly draw the correct tubes needed for all tests. Loosen the tourniquet and withdraw the needle while simultaneously placing gentle pressure on the needle site with gauze. Hold pressure on the site for a minute or so and then bandage.

Before the Patient Leaves

  • After you have completed the procedure, you should ask if the patient is feeling well. If he is not, get an ice pack and have him remain in the chair until he feels better. Be sure to advise the patient not to do anything too strenuous for a few hours using the the arm that was tested. Always thank the patients before they leave. No one enjoys having his or her blood drawn. It is the phlebotomists' duty to make this as simple and easy a process as possible. Treat each patient as if they were a family member, and always be polite and kind, no matter how the patient acts.

Important to Remember

  • If you are not comfortable with your ability to draw blood from a particular patient, ask someone else who is qualified to help to step in.

    Do not blindly stick a patient in the hopes of getting blood.

    Do not tell the patient to bend his arm at the elbow. That can encourage bruising to occur.

    Never continue to draw a patient who tells you that he is in pain. Phlebotomy should not be painful, and if a patient says it is, there is a possibility that you hit a nerve.

    Never tell a patient what the blood test checks for. Different tests are used for different things, and unless you are the ordering physician, you cannot answer that question. Advise the patient to contact his doctor with any questions.

References

  • Phlebotomy Essentials; Ruth E. McCall, 2003
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